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Fungal malignant otitis externa treated with hyperbaric oxygen.

Shane S Ling¹, Chady Sader

¹Otolaryngology Department, Royal Perth Hospital, Wellington St, Perth, Western Australia 6009, Australia. shanus@iinet.net.au

International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases

|May 30, 2008

Summary

Aspergillus flavus is a rare cause of malignant otitis externa. Successful treatment involved antifungal agents, surgical debridement, and hyperbaric oxygen therapy for this fungal infection.

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Area of Science:

Infectious Diseases
Otolaryngology
Mycology

Background:

Malignant otitis externa (MOE) is a severe infection of the external auditory canal.
While typically bacterial, fungal causes like Aspergillus flavus are rare but serious.
Diabetes mellitus is a known risk factor for invasive fungal infections.

Observation:

A 77-year-old male with non-insulin dependent diabetes presented with otalgia and purulent otorrhea.
Clinical presentation suggested a severe external ear infection.
Radiological and histological findings were crucial for diagnosis and monitoring.

Findings:

The case confirmed Aspergillus flavus as the causative agent of malignant otitis externa.
A multimodal treatment approach was effective.
The patient showed positive outcomes with the combined therapy.

Implications:

This case highlights the importance of considering fungal pathogens in refractory otitis externa, especially in diabetic patients.
Aggressive management combining surgical debridement, targeted antifungal agents, and hyperbaric oxygen therapy is recommended.
Further research into fungal MOE is warranted to optimize treatment strategies.